Known methods for tracking drugs, particularly narcotics, in hospitals or the like have been manual. The narcotics are typically located in a narcotics safe. The removal of drugs from the drug safe for distribution to nursing stations while tracking the removal is a very time intensive procedure prone to inaccuracies, as is the tracking of the addition of drugs to the narcotics safe. Typical manual tracking procedures are as follows.
In order to distribute the drugs from the safe to the nursing stations, a "pick-list" is first manually generated. A hospital technician gathers drug disposition records and 24 hour nursing audit records from each nursing station. Based upon these records, the technician determines the quantity of each drug at a nursing station and then determines whether that quantity of the drug is below a par level for that particular nursing station. If the final count of a drug is below the par level, an entry is manually made on a pick-list for that nursing station including information identifying the nursing station, the drug name and its strength, and the quantity required to bring the nursing station up to par level for the particular drug. Once all of the disposition records for all of the nursing stations have been processed in this manner, the technician takes the pick-list to the drug safe.
The technician gathers the required quantity of each drug listed on the pick-list for a particular station, one drug at a time. If the required quantity of a drug is contained in a box, the technician writes the nursing station and current date on the box. Otherwise, the drugs are placed in a resealable bag and the nursing station and date are handwritten on a label and the label affixed to the bag. The drug is then checked off from the pick-list for that particular nursing station. When all of the drugs for a nursing station have been picked, the drugs are bundled together with a rubber band and placed aside while the technician picks the drugs for the remaining nursing stations.
When the drugs have been picked for all of the nursing stations, the technician then fills out a Stock Replacement Work Sheet which consists of a large grid with rows representing each nursing station and columns representing each drug that is tracked. For each nursing station on the pick-list and for each drug required for that particular nursing station, the quantity of the drug picked or removed from the safe is recorded in the grid cell in association with the particular nursing station and drug. Then for each drug on the Stock Replacement Work Sheet, the technician adds the entries for the drug and places a total in the last row in association with the drug column. The Stock Replacement Work Sheet is then used to update the Drug Logs for each drug that was picked.
In accordance with government regulations, each drug has an individual Drug Log that records each transaction that occurs involving the drug. In order to update the Drug Logs for each drug that was picked, the log for the particular drug must be manually retrieved and the following information entered: the current date, the total amount picked as indicated on the Stock Replacement Work Sheet, the technician's initials, a code representing the destination of the drug, and a new balance which is calculated by taking the last balance of the drug and subtracting the amount picked.
Thereafter, a physical inventory of the drug is performed whereby the technician counts the quantity of the drug remaining in the safe. The technician then compares the counted quantity remaining to a balance recorded in the Drug Log for the particular drug. If there is a discrepancy, the technician must find the cause of the discrepancy, i.e. math or entry error and correct it. If the technician cannot determine the cause of the discrepancy, a discrepancy report is filed. It is also not uncommon for drugs to be picked from the safe at irregular intervals before or after the picking process occurs. In these situations, because of the typical urgency to deliver the drug to its intended destination, the Drug Log may not be accurately updated resulting in discrepancies.
When drugs are to be added to the drug safe from a wholesaler or are returned from a nursing station, they must also be recorded on the drug logs. For each drug received, the drug is counted and the Log for the drug is obtained. The technician then manually records the current date, the total amount of the drug counted as being received, the technician's initials, the source of the drugs i.e., the identity of the nursing station or the wholesaler, and a new balance which is calculated by taking the last balance of the drug and adding the amount received. A physical inventory of the drug is then performed. The technician then compares the recorded balance on the Drug Log to the balance resulting from the physical inventory of the drugs. Again, if a discrepancy is found, the technician must find the cause of the discrepancy and correct it or file a discrepancy report.
Each month, the drugs in the safe are also examined to locate any that have passed their expiration date. Outdated drugs are removed from the area in the safe from which the drugs are dispensed to nursing stations and are placed in a separate location in the safe until they are disposed of. For each outdated drug that is removed to the separate disposal location in the safe, the Log for the drug is pulled and the following information recorded: the current date, the quantity of the drug being outdated, the technician's initials, a code representing the destination, i.e. the outdate location within the safe or a destruction location and a new balance which is calculated by taking the last balance of the drug and subtracting the amount being outdated. A physical inventory of the drug is then performed as discussed above with discrepancies either being corrected or being accounted for by the filing of a discrepancy report. An entry is also manually made in a Discarded Meds Drug Log for outdated drugs. This Log tracks the outdated drugs until they are disposed of and contains the same information as the regular Drug Logs. The manual entry of the required information by handwriting the entries or even by manually entering the information into a computer is expensive, labor intensive and is prone to inaccuracies requiring many hours to resolve and to report the discrepancies.
Automatic systems for dispensing drugs are known such as described in U.S. Pat. No. 5,762,235. However, these systems do not track the location of the drug.